Sleep Apnea
Millions of Americans suffer from the effects of sleep apnea. When
patients with this disorder sleep, the muscles of their throat and
neck relax, which allows soft tissue to block the airway. Snoring
results if the airway is only partially blocked, but when the airway
obstructs completely, the person temporarily stops breathing. Doctors
refer to this cessation of breathing as apnea. Since this serious
condition occurs at night, physicians use the term sleep apnea.
Once a person stops breathing, he or she wakes up briefly and then
falls back asleep. This cycle of respiratory cessation and arousal
repeats itself over and over. Some people with the most severe cases
can stop breathing up to an alarming 150 times in a single night.
This recurrent pattern disrupts the normal sleep cycle, and individuals
with sleep apnea never feel fully rested. Consequently, patients
with this illness fall asleep frequently during the day. In extreme
cases, patients can doze off during the course of a conversation
or even behind the wheel of a car while driving. Some sufferers
also experience extreme fatigue and difficulty staying awake at
work, which can result in the ultimate loss of their jobs.
Doctors screen patients for sleep apnea by observing their physical
appearance and asking a few simple questions. Since the condition
occurs more commonly in the obese population, heavy individuals
heighten physicians’ index of suspicion. Professionals delve
further by asking about the telltale signs of frequent napping during
the day, excessive daytime sleepiness, and snoring at night. In
addition people with sleep apnea sometimes complain of waking up
with severe headaches.
If you describe symptoms typical for sleep apnea, your doctor may
order an overnight sleep study. During this procedure, a technician
observes the sleep of a patient in a laboratory that is equipped
with a comfortable bed and surroundings similar to a hotel room.
Instruments monitor the oxygen level over the course of the night
along with the chest wall movements, airflow from the nose, leg
movements, brain wave patterns and an electrocardiogram. With the
detection of patterned breathing cessation, the laboratory will
diagnose sleep apnea.
Upon the confirmation of sleep apnea, your doctor will probably
recommend sleeping with a special mask called CPAP along with weight
loss. The CPAP (continuous positive airway pressure) blows a small
amount of air through the nose into the back of the throat. This
pressure keeps the airway open and prevents the airway from occluding.
A dramatic and overall improvement in well-being is usually reported
by individuals with the use of CPAP. In rare cases, this mask might
not help patients and physicians may recommend surgical procedures
to remove the excess tissue in the throat and soft palate.
Narcolepsy
Narcolepsy is a rare disorder. Sudden and abrupt falling asleep
without warning characterizes this condition. Sufferers perform
their normal and usual daily tasks that may include driving, operating
equipment, and talking on the phone among other activities, only
to drop off to an unexpected sleep. Patients with narcolepsy also
suffer from an associated cluster of symptoms including sleep paralysis
and cataplexy. Cataplexy is the sudden loss of muscle tone following
an emotional response such as laughing. Sleep paralysis describes
the sensation of being alert associated with a complete inability
to move. This usually occurs just prior to arousal in the morning.
Physicians specializing in sleep disorders, use a multiple sleep
latency test to diagnosis narcolepsy. Patients go to the lab for
the procedure after a full nights sleep. Individuals with this disorder
will fall asleep in the correct environment despite being well rested.
In addition, the EEG pattern and eye movements of patients with
narcolepsy demonstrate a tendency to fall immediately into the rapid
eye movement (REM) phase of sleep. This distinguishes them from
normal individuals who gradually progress from the early stages
of sleep to the REM sleep.
After diagnosis, physicians treat the disorder with medications.
The two most frequently prescribed medications are Ritalin and Provigil.
These medicines keep patients awake during the day and prevent the
sudden, unexplained sleep attacks typical in narcolepsy.
Insomnia
Insomnia is the inability to fall asleep at night. Patients toss
and turn frequently, sleep only for brief periods, and have a sense
of overwhelming tiredness during the day. Doctors treat insomnia
effectively using a combination of behavioral therapies and medications.
Physicians usually recommend adjusting the patient’s schedule
to retire at the same time each night and wake up at the same time
every morning. Behavioral modifications also include using one’s
bed only for sleeping and not reading or watching television in
bed during daytime hours. When behavioral modifications alone fail
to rectify the problem, most experts prescribe non-addicting sleeping
aides such as Trazadone or Ambien.
Upper airway resistance syndrome
This sleep disorder usually causes severe snoring and intermittent
waking during the night. Although patients do not stop breathing
completely as in sleep apnea, the partial occlusion of their upper
airway causes snoring and arousals during the night. These arousals
disrupt a person’s sleep and lead to fatigue during the daytime
hours. Experts usually treat this disorder with continuous positive
airway pressure (CPAP) in a manner similar to sleep apnea.
Restless leg syndrome
Restless leg syndrome describes a poorly understood condition in
which patients kick and thrash their legs repeatedly during the
night. This constant movement disrupts the patient’s sleep
and results in repeated awakenings during the night. These recurrent
awakenings in turn lead to sleepiness during the day. Physicians
diagnose this syndrome using an overnight sleep study (polysomnography).
Once a diagnosis of restless leg syndrome is established, physicians
prescribe medications such as Klonipin and Sinemet for treatment.
These medications usually alleviate the symptoms of kicking during
the night and sleepiness during the day.
Parasomnias
Parasomnias are abnormal behaviors during sleep. Sleepwalking and
night terrors are the most well known parasomnias. Once again, physicians
use overnight sleep studies (polysomnography) to diagnose these
disorders. If an overnight sleep study demonstrates a parasomnia,
physicians prescribe medications and behavioral therapies to treat
the problem.
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